Abstract
Sinus lift with a simultaneous implant placement in the residual maxilla is a common technique used worldwide. Nevertheless, choosing an ideal grafting material remains an object of dispute. The use of an autologous blood-derived graft, known as platelet-rich fibrin (PRF), has not yet been recognized to be as good as xenografts and alloplastic materials. However, initial results have been promising. To conduct a clinical and radiological comparison of implantation with a simultaneous sinus lift using xenograft or PRF clots. Thirty sinus lifts with simultaneous implantation were conducted using a lateral window approach and the tent pole technique, with xenograft (group 1 (G1)) or PRF (group 2 (G2)) as a filling material. To be included in the study, patients must have had an alveolar ridge height of 4-5 mm, no signs of inflammatory processes, good oral hygiene, and no other grafting procedures performed in region of implant insertion. In each case, the measurements taken were probing pocket depth (PPD), height of keratinized tissue (HKT), clinical attachment level (CAL), recession depth/width (RD/RW), and, on panoramic X-rays, marginal bone loss (MBL), grafted sinus high (GSH), and bone gain (BG). Preand post-operative treatment was applied to reduce the chance of infection. During the study, 30 implants (hydroxyapatite-coated implants manufactured by SGS - 10 mm in length and 4.2 mm in diameter) were placed. The survival rate of implants in both groups was 100% with no implant mobility, pain, paresthesia, or inflammatory processes in the direct vicinity of the implants observed, except in 1 patient. After 36 months of follow-up, the radiological assessments for G1 were: GSH 4.5 mm, MBL 0.46 mm and BG 4.53 mm; and for G2: 3.4 mm, 0.6 mm and 3.4 mm, respectively. Results of the clinical measurements were for G1: HKT after 36 months (HKT36) 2.46 mm, CAL 0.47 mm and PPD 2 mm; and for G2: HKT36 3.13 mm, CAL 0.6 mm and PPD 2.07 mm. After 3 years of follow-up, the results of sinus lifting solely using PRF with simultaneous implantation were promising, especially in terms of soft tissue management. Therefore, PRF can be regarded as an alternative to previously used materials.
Highlights
Sinus lift with a simultaneous implant placement in the residual maxilla is a common technique used worldwide
30 implants were placed
Results of the clinical measurements were for G1: height of keratinized tissue (HKT) after 36 months (HKT36) 2.46 mm, clinical attachment level (CAL) 0.47 mm and probing pocket depth (PPD) 2 mm; and for G2: HKT36 3.13 mm, CAL 0.6 mm and PPD 2.07 mm
Summary
Sinus lift with a simultaneous implant placement in the residual maxilla is a common technique used worldwide. In cases with a height over 6 mm, transcrestal techniques can be conducted.[5] In contrast, when the bone level is insufficient, procedures with an approach from the lateral side of the sinus cavity are most commonly used. This technique creates space between the maxillary alveolar process and the elevated Schneiderian membrane, which is filled with various grafting materials to maintain adequate space for new bone formation.[3,4,5]
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